Friday, February 20, 2009

Six Future Trends in Psychiatry

Henry Nasrallah in the Feb issue of Current Psychiatry describes 6 trends that will affect the practice of psychiatry.

  1. Earlier diagnosis and treatment.
  2. Genetic discoveries
  3. Targeting of neuroplasticity.
  4. Neurostimulation, as in VNS, TMS, DBS.
  5. Psychopharmacogenetics.
  6. Intertwining of physical and mental disorders.
What do you all think?

17 comments:

Anonymous said...

Any patient can tell you that number 6 is not a future trend, it simply is. Why has it taken psychiatry so long to catch on?

DrMom said...

I think Henry is right... but alas, I think it will mean a lot less for today's psychiatrist to do. Neurosurgeons, neurologists will be taking over our patients.
Makes me sad.

Anonymous said...

Perhaps psychiatrists could return to being the gold-standard of psychotherapy. :)

I would NEVER allow neurostimulation or psychopharmacogenetics to be performed on me.

Owais said...

How about:
#7) Dispelling pseudoscience and fear-mongering conspiracy theories about Psychiatry

Aqua said...

I agree with the first Anonymous. The disdinction between "mental" and "physical" illnesses is the biggest mistake medicine has ever made. Many many so called physical illnesses are impacted, or even triggered by mental states like stress and environmental and genetic causes...just like mental illness. The split has only fed the stigma surrounding mental illnesses; a stigma that is simply not found in most physical illnesses.
...aqua

wetnurse said...

My prediction:

Similar to the manner in which all but a tiny fraction of the U.S. population is somewhere on the bipolar 1-12 spectrum, Pharma will soon partner with Google (using the technology that enables Google to generate sponsored links that correspond to topics found within the contents of your gmail messages) to introduce a procedure for diagnosis based on cumulative data from an individual's web surfing habits and electronically notifying their physician of the lucky patient's "diagnosis", for which, naturally, the only treatment is one or more medications in the $600/month range that are of dubious efficacy but certain toxicity.

And now I'm off to seek a cure for run-on sentences.

Anonymous said...

Wetnurse,
Your run-on sentence proves that you are Bipolar 8.

Anonymous said...

Tell clink I miss her too. abf

Sarebear said...

psychiatrists as thinly disguised pharmaceutical reps (wait, we already have these . . . . . woops.)

yeah, on that googling thing, heh.

hey, go come up w/some diagnoses of me based on my Kaboodle list. They are not all wishes, sometimes I've been forced to sit at my computer for days until all the tabs I've opened have been kaboodled (sorted, categorized, etc.)

Yeah, OCD. I even put that in my Kaboodle profile, heh.

And one might think hey it's scary what one can find out about you by looking at this, one reason i haven't put it on my blog, but many many of the lists are hey if i ever have a zillion dollars, or hey, I've caught the "design" bug and really like the look of these designer chairs, etc. Hee, check out the seating categories, it's SICK.

Literally. I feel . . . . sad when I look at those categories a little, right alongside the satisfaction of the OCDilly (made up a word ha) level of pleasure from having sorted items like that . . . .

Some of the stuff on there has SO little to do w/me, some does tho.

Anyway, speaking of diagnosing via google, or the web habits of people, seriously I've thought, if any doc had a look at this, um, yeah . . . . lol.

Altho I made a If You are a Hopeless____ w/subcategory of Neuro stuff, just for you guys here, all brain themed, hee.

And then there's the rubber duckies . . . .

ah, well, see, you can see the obsessiveness and compulsions starting. I am NOT going there. Not tonight.

Sarebear said...

er, was kidding on the come up w/some dx of me based on those lists, but go have a look anyway.

I'm obviously OCD so that's already out of the way, lol. (word verify agrees w/me, outse)

Barbara K. said...

interesting list. what about complementary/alternative approaches? and do you think in addition to mind and body, spirit can have a role to play?

Roy said...

Agree with Aqua and Barbara K (& anon1): integration of a more holistic approach is ongoing "trend" though I think that has been the case for decades, and will continue to be so. There are some who mostly practice and think along these lines... and others who mostly do not. I don't think this will change.

I think #7 mentioned by Owais is represented in the ongoing (ad infinitum, possibly) de-stigmatization of psychiatry and mental illness.

Love the Google diagnosis bit. Hmm, then maybe Google Flu Trends is a precursor to that.

wetnurse said...

A bipolar 8, you say?

If I tell you that I once purchased 2 pair of shoes in a single shopping trip, do I get a qualifier?

Or points for knowing that was a run-on sentence?

I'm ashamed to admit that I was not familiar with Google Flu Trends. Some nurse I am.

Anonymous said...

IANAD, but where has Henry Nasrullah been the last 10-15 years WRT item 6? Isn't the linkage of physical and mental disorders common knowledge?

I'm hoping non-invasive neurostimulation will be proven effective for BPII, ending the need for Rx roulette...

Mike said...

The mind is a product of the brain, what happens to the brain therefore affects the mind. It's common sense.

Yet alot of people receive "therapy" and "treatment" without so much as a simple medical history being provided.

Prior to any psychological therapy being given a thorough medical history should be provided. Then a physical, blood work-up and any additional tests to preclude a medical basis for the psychological symptoms.

How many people recieve therapy for depression and actually suffer from hypothroidism.

Or a person that suffers an hypoxic/anoxic episode that results in cognitive deficits being "treated" with psychoanalysis.

The whole mental health field needs to be reworked from the ground up. It should be based on science and common sense.

There are psychoanalyists, social workers, and a whole hosts of others with some letters of the alphabet after their name enriching themselves offering useless "therapy". People suffer and sometimes die as a consequence.

The Hippocratic Oath should apply to those who treat the mind as to those who treat the body.

"First do no harm"

Clare said...

For the person who insulted social workers and psychotherapists: there are a whole host of social workers and therapists who practice EMDR or other neuropsychology-based forms of therapy...we are way more cutting-edge than you may realize. Francine Shapiro PhD who is the pioneer of EMDR came up with it in 1987. Regarding the therapists who continue to practice traditional forms of psychotherapy, there are a lot of people who actually benefit from therapies where they are questioning belief systems that no longer work for them. So before you make blanket derogatory statements, you may want to learn more about what's actually out there.

Akash Kumar said...

Sad truth: Nurse practitioners (some of whom think they know what they are doing but really do not) are the future of psychiatry. They are much cheaper, and health systems really don't care about providing the best care, especially not when it costs double. Very sad. We worked so hard to perfect my craft, and we are replaced.